Time for Physicians to Take Care of Business (Part II)

Last week, James Doulgeris began talking about the growing divide in U.S. healthcare given reform initiatives and other factors. Here, he continues to discuss the new healthcare environment and the role of private practice physicians.

Physicians, who should be playing a pivotal role in solving the crisis, are dispersed, fragmented practitioners in a coalescing world of corporate providers and payers, and the tipping point from physician employers to physician employees has already been reached and passed.

Dr. Meyers, an educator, identifies the progenitor of the growing physician disadvantage. Complacency and a false sense of security that things have not changed, or worse yet to pull back when the situation requires moving forward, threatens to be the undoing.

The growing disadvantage of a fragmented and inefficient independent physician system in an era of consolidation and growing productivity leaves physicians vulnerable and disenfranchised. Six of 10 physicians are already employees, and hospitals and insurers are hiring.

Independent physicians are in the best position to innovate, enhance technology and techniques and to advocate for their patients.

If physicians do not consolidate into natural groups and run like businesses under their own terms, and soon, they cannot earn a meaningful seat at the table with institutional and governmental providers and payers. Without that seat, the system is unbalanced.

If physicians can consolidate with each other and in the interest of their patients to become an independent, powerful, and united voice in the public discourse, there is hope.

That is not to say that physician-hospital-payer partnerships are not important, they are, because when physicians are partners, there is a strong voice to put patients first, and to promote prevention to reduce intervention. That is also not to say that hospitals do not put patients first, but their focus, and business, is managing episodic acute care. Physicians manage lifelong care. They are the key to educating patients on how to become and stay healthy. They manage chronic conditions. They are the front line in reducing obesity, smoking, and encouraging physical activity - the three primary keys to reducing and preventing cardiovascular disease, diabetes, cancer, stroke and chronic pain - the five primary healthcare expense categories. Physicians are the agents of change who must play the pivotal role in solving the root problems of healthcare.

Failure to act now leads to inevitable financial disadvantage and inefficiency, and both are severely punished in any marketplace. Consolidators from hospitals to drug stores to physical therapy providers are joining together with the power to negotiate preferred pricing and reimbursements while they maximize the benefits of economies of scale. They work on improving every day. They are run by business professionals who know healthcare. They are preparing for the future.

Physicians will be well advised to follow suit, and aggressively. The experienced business talent is there, particularly on the strategic side. They are the people with comprehensive solutions and skills. They require an investment, one that can deliver great returns not only to practices that join together, but to the system as a whole.

If not, physicians will still have a voice, but likely not a choice or control of their own destiny - that is the nature of employment.

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